Along with these symptoms, you also have symptoms of schizophrenia: a loss of touch with reality, abnormal thinking, hallucinations, delusions and/or extreme paranoia.

It may take a while for psychiatrists to make the diagnosis. Some people with schizoaffective disorder have both depression and mania, but seek help only when they’re depressed and never mention the mania.

To complicate matters, another illness — bipolar disorder — also produces highs and lows in mood, and racing thoughts. However, people with schizoaffective disorder have moments where they are quite paranoid and out of touch with reality.

For the family, education and counseling are extremely helpful. The National Alliance on Mental Illness is a great resource. County mental health boards, and local hospitals and mental health centers may also offer support groups.